A surprising finding from this Healthwatch publication about care homes, based on national 'Enter & View' reports is that despite feedback being a strong CQC theme, with assessments based largely on stakeholder feedback, too many care homes are not actively seeking feedback for themselves, or they fail to act on feedback or be transparent and open about findings. Healthwatch really focus on the importance of feedback; they introduce it as a central theme; they include it in the 8 Quality Indicators; they emphasise the need to seek out and respond to feedback and they include it as one of the key lessons for carehomes.
But what do they mean by feedback? We all have our internal feedback loops enabling us to adjust and tweak our way through life; but some people try to extrapolate this mechanism as being OK for an organisational setting: the old " I talk to my staff; I know what's happening in my home" approach. But care homes are complex organisations regardless of size and this native, organic approach to feedback is simply not adequate.
The feedback loop is classic recommendation for good management; and care homes require a multi channeled approach to feedback with robust and consistent mechanisms that exploit opportunities for feedback whenever possible. Moreover the feedback system needs to be embedded into the organisational culture and used as a platform for communications and engagement.
In this example, standing processes for 'Suggestions' and 'Complaints' are in place. These form subject matter for the monthly staff meetings and the quarterly residents and relatives forum.
Similarly the normal daily interactions with both residents and staff, whilst informing immediate behaviour can yield interesting insights that may warrant further discussions at staff meetings and the forum. These therefore become essential parts of the organisations communication process and become the platform for engagement and involvement, really improving management and leadership, better decision making and supporting any change or improvement initiatives.
The foundation stone for this process is the annual bench-marking activity. This lets you measure opinions and levels of satisfaction giving you a performance indicator; it tests assumptions and theories and lets you measure what people are really thinking, giving a metric for ongoing improvement.
What really makes this process work is quality communications and sustained use of the process; people know about the suggestion scheme and they know that ideas will be examined and discussed; they know how to make complaints and that any complaints will be discussed and dealt with effectively. They know that staff meetings are taken seriously, that the forum is a legitimate place for discussions, that they will take place when scheduled, that the management really value their input.
The annual bench-marking exercise also needs to test opinions across the breadth of stakeholders and be consistent and reliable. The Care2improve quality audit system elicits feedback from care users, from relatives, from staff and from other professionals; it tests opinions against all of the key quality outcomes outlined by CQC and delivers both quantitative and qualitative analysis. It creates an excellent platform for an embedded, robust QA system.